Journal of Foot and Ankle Surgery (Asia Pacific)

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VOLUME 5 , ISSUE 2 ( December, 2018 ) > List of Articles

CASE REPORT

Primary Giant Synovial Osteochondroma of Ankle

Jai P Khatri, Ajaydeep Sud, Vandana Rana, Munish Sood, Uddandam Rajesh

Keywords : Ankle, Giant synovial osteochondroma, Primary

Citation Information : Khatri JP, Sud A, Rana V, Sood M, Rajesh U. Primary Giant Synovial Osteochondroma of Ankle. J Foot Ankle Surg Asia-Pacific 2018; 5 (2):73-76.

DOI: 10.5005/jp-journals-10040-1094

License: CC BY-NC 4.0

Published Online: 01-12-2018

Copyright Statement:  Copyright © 2018; The Author(s).


Abstract

Background: Giant synovial osteochondroma (SOC) is a clinical variant of synovial chondromatosis wherein the size of the osteochondral nodule exceeds 2 cm. This is a rare clinical entity and finds its description in a few case reports or case series only. Case description: A 28-year male patient presented with swelling of the ankle region for 5 months duration. Plain radiograph of the ankle showed well circumscribed, increased soft tissue density lesion in the posterior aspect of tibiotalar joint and talus. Magnetic resonance imaging (MRI) of the ankle showed a smoothly marginated lesion close to the tibiotalar joint which was heterogeneously hypointense on T1-weighted images and hyperintense on T2-weighted images. Hypointense foci within the lesion in both images were suggestive of ossification. Intraoperatively, the swelling was noted to arise from the tibiotalar joint capsule with no evidence of bony erosion. The mass was excised in toto, and wound closure was done in layers. Microscopic examination of the mass showed predominant chondroid element with irregularly distributed chondrocytes in lacunae and evidence of enchondral ossification along with cancellous bone mass suggesting a synovial osteochondroma. On postoperative follow-up at 2 months and 9 months, movements around ankle joint were full range and pain-free with no reappearance of swelling. Imaging including plain radiograph and MRI revealed no evidence of recurrence at 9 months. Conclusion: Giant SOC can present itself with the variety of symptoms. Imaging is helpful in ascertaining the diagnosis. The treatment of the condition remains surgical only. Post surgery, recurrence remains a possibility. Clinical significance: Giant SOC should form one of the clinical possibilities in swellings arising from synovial joints as early diagnosis of the condition can prevent arthritic changes to progress further.


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  1. Edeiken J, Edeiken BS, Ayala AG, Raymond AK, Murray JA, Guo SQ. Giant solitary synovial chondromatosis. Skeletal Radiology. 1994 Jan 1;23(1):23-29.
  2. Fornaciari P, Schai PA, Niehaus R, Exner UG. Intra-articular giant synovial osteochondroma: case reports of the ankle and knee joint. Case Rep Orthop. 2015;2015.
  3. Aydin N, Gokkus K, Topal C, Aydin AT. Solitary synovial osteochondroma of the knee: mimicking a giant loose body. International Medical Case Reports Journal. 2012;5:83-86.
  4. Robinson D, Hasharoni A, Evron Z, Segal M, Nevo Z. Synovial chondromatosis: the possible role of FGF 9 and FGF receptor 3 in its pathology. International Journal of Experimental Pathology. 2000;81(3):183-189.
  5. Allahabadia VN, Kulkarni SS, Dogra AS, Bhosale PB. Solitary synovial osteochondroma of the knee. J Postgrad Med. 1995;41(4):113-114.
  6. Milgram J W. Secondary synovial osteochondromatosis. Bulletin of the Hospital for Joint Diseases. 1979;40:38-54.
  7. Khan Z, Yousri T, Chakrabarti D, Awasthi R, Ashok N. Primary synovial osteochondromatosis of the first metatarsophalangeal joint, literature review of a rare presentation and a case report. Foot Ankle Surg. 2010;16:e1-e3.
  8. Kumar A, Aggarwal A, Sahni VK. Primary synovial osteochondromatosis of a subdeltoid bursa. Indian J Orthop. 2010;44(1):104-107.
  9. Cohen AP, Giannoudis PV, Hinsche A, Smith RM, Matthews SJ. Post-traumatic giant intraarticular synovial osteochondroma of the knee. Injury. 2001;32:87-89.
  10. Al-Najjim M, Mustafa A, Fenton C, Morapudi S, Waseem M. Giant solitary synovial osteochondromatosis of the elbow causing ulnar nerve neuropathy: a case report and review of literature. J Brachial Plex Peripher Nerve Inj. 2013;8(1):1.
  11. Lui TH. Giant Solitary Synovial Osteochondroma of the Subtalar Joint. J Foot Ankle Surg. 2016 Jan-Feb;55(1):183-187.
  12. Osti L, Papalia R, Buono AD, Denaro V, Maffulli N. Recurrence of synovial chondromatosis of the Hoffa's body. Knee Surgery, Sports Traumatology, Arthroscopy. 2009;17(12):1421-1424.
  13. Yu X, Li W, Dai M, Zhang B, Zou F, Liu H. Giant extra-articular synovial osteochondromatosis of the left proximal thigh: A case report. Oncol Lett. 2015;10(6):3577-3580.
  14. Anract P, Katabi M, Forest M, Benoit J, Witvoët J, Tomeno B. (Synovial chondromatosis and chondrosarcoma. A study of the relationship between these two diseases). Rev Chir Orthop Reparatrice Appar Mot. 1996;82(3):216-224.
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